Provider Demographics
NPI:1598532467
Name:WASHINGTON, TAKESHA L
Entity Type:Individual
Prefix:
First Name:TAKESHA
Middle Name:L
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 SW 68TH LN
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6647
Mailing Address - Country:US
Mailing Address - Phone:305-335-7363
Mailing Address - Fax:
Practice Address - Street 1:4013 SW 68TH LN
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6647
Practice Address - Country:US
Practice Address - Phone:305-335-7363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula